Monkeypox: Symptoms, Treatment, and Vaccine

Monkeypox 101

Monkeypox joins its old cousin, smallpox, in the viral family of orthopoxviruses (or poxviruses for short). The first animal case was a monkey (hence the name) in 1958.

After a human is infected, they can infect other humans through several avenues:

  1. Respiratory droplets and aerosols from prolonged face-to-face contact;

  2. Contact with bodily fluids or monkeypox lesions;

  3. Indirect contact with items that have been contaminated with fluids or sores, like clothing or bedding.

Monkeypox has a long incubation period, which means the interval from infection to onset of symptoms ranges from 5 to 21 days. In general, poxviruses rarely transmit prior to disease onset, which means there is little asymptomatic spread. The distinctive symptoms of human monkeypox greatly aid in its containment.

Once someone is infected they can be sick for 2-4 weeks.

When to Suspect / Test for Monkeypox

  • High risk sexual activity: Unprotected intercourse, multiple partners

  • Had contact with someone who had a rash that looks like monkeypox or someone who was diagnosed with confirmed or probable monkeypox

  • Traveled outside the US to a country with confirmed cases of monkeypox or where monkeypox activity has been ongoing

  • Vesicular, pustular, umbilicated, or papular lesions. May or may not be preceded by a prodrome of fevers, myalgias, headaches, and lymphadenopathy

Treatment

  • Treatment: Effective therapeutics have already been developed but not widely available. The antiviral ST-246 (tercovirimat), for example, was developed specifically for smallpox but works for all orthopoxviruses including monkeypox. We will hear more about this drug in the next coming weeks to months. 

  • Other mitigation measures: COVID-19 mitigation measures, like masks and improved ventilation and filtration, will help with reducing spread. In fact, in 2021, a monkeypox case landed in Dallas from Nigeria. It’s largely hypothesized that the mask mandate helped contain the virus.

VACCINE

At this time, vaccines are only being offered in NJ for POST EXPOSURE Prophylaxis.

Only the NJ DOH (Department of Health) can approve and administer the vaccine. 

If a patient wishes for a vaccine they will need to contact the DOH themselves and get their names on the waiting list. Getting your name on a waiting list does not guarantee vaccination.

Resources

New Jersey State DOH: 609-826-5964

New Jersey Local DOH: https://www.state.nj.us/health/lh/community

New York State DOH: 518-473-4439

NYC DOH: 347-396-2600

CDC Emergency Operations Center: 770-488-7100

 

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